Royson Jerome Dsouza, (2020) Effectiveness of Early Electrical Neuromuscular Stimulation in Functional Recovery of the Facial Nerve after Excision of Benign Superficial Lobe Lesions of the Parotid Gland. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION: Parotid tumours constitute 80% of the salivary gland neoplasms which often require surgical resection. For benign lesions involving the superficial lobe of the parotid gland, superficial, adequate or extracapsular parotidectomy are the preferred surgical options. Facial nerve paresis is the most common, yet the most serious complication after parotidectomy, which can occur in 30-60% of the patients. The recovery in temporary paresis is known to occur between three to six months but can be delayed up to two years. Currently, there are no modalities of therapy with proven benefits to fasten the recovery of facial nerve paresis. Hence, this study was undertaken to assess the effectiveness of electrical neuromuscular stimulation in the recovery of facial nerve paresis after parotidectomy. AIM OF THE STUDY: The study aims to assess the benefit of electrical neuromuscular stimulation in functional recovery of the facial nerve after the excision of benign superficial lobe lesions of the parotid gland. OBJECTIVES: 1. To determine the incidence of facial nerve paresis following superficial parotidectomy, adequate parotidectomy, and extra-capsular parotidectomy after six weeks of electrical neuromuscular stimulation. 2. To compare the House Brackmann scores between the study group and the historical controls. 3. To assess the feasibility and safety of electrical neuromuscular stimulator for domiciliary use by the patients. METHODS: A single-arm clinical trial was conducted on 23 patients who underwent superficial, adequate and extracapsular parotidectomy for benign parotid tumours from December 2017 to April 2019. They were recruited on the postoperative day 2 if they had a House Brackmann score between II to V. Following this, they underwent electrical neuromuscular stimulation for six weeks. The House Brackamnn scores were reassessed on postoperative day 8 and day 42. These scores were compared with the patients who did not receive the therapy post-operatively from the historical data. RESULTS: The recovery of the facial nerve was assessed individually in each of the temporal, zygomatic, and marginal mandibular branches of the facial nerve. The prevalence of normal facial nerve function (HBS 1) improved from 17% on postoperative day 2 to 91% on postoperative day 42 in temporal nerve. Similarly, it was 21% to 86% for zygomatic nerve and 0 to 60% for marginal mandibular nerves respectively. On comparison of the House Brackamnn scores of the study patients with the historical controls, the recovery of the facial nerve was faster with the use of electrical neuromuscular stimulation. The results were statistically significant (p < 0.05). There were no therapy-related side effects or complications observed during the study. The device for feasible and safe for domiciliary use by the patients. CONCLUSION: The use of electrical neuromuscular stimulation in the early postoperative period after superficial, adequate and extracapsular parotidectomy results in faster recovery of the facial nerve paresis. The study has also shown the feasibility and safety of domiciliary use of the device. However, further larger randomized control trials are recommended to support the same.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711459 |
| Uncontrolled Keywords: | Parotidectomy, Facial nerve paresis, Rehabilitation of facial nerve, Electrical neuromuscular stimulation. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Feb 2021 16:55 |
| Last Modified: | 12 Feb 2021 16:55 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14067 |
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